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1515 Beach Ave - FNCE20-0023 41c4 s'=�'ir� City of Atlantic Beach APPLICATION NUMBER \ Building Department (To be assigned by the Building Department.) 800 Seminole Road /l .- Atlantic Beach, Florida 32233-5445 f iCE��- v sPhone(904)247-5826 Fax(904)247-5845 7�--,-Lona,— E-mail: building-dept@coab.us Date routed: ( [�Z-CM City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: -'� 1 Et0_,e( 3 ' : • -nt review required Yes No :uildin• Applicant: r2VYNS l 46l_ ' , — anning &Zoning Tree Administrator Project: 4 6 PE--1 t�C� 'ublic Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept.of Environmental Protection Florida Dept. of Transportation / St.Johns River Water Management District l Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. Denied. of applicable (Circle one.) Comments: BUILDING PLANNING &ZONING ??v �- Reviewed by: a -�- Date: _ 9 ZO TREE ADMIN. Second Review: I Approved as revised. (Denied. I 'Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. I 'Denied. I 'Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Ft - Building Department (To be assigned by the Building Department.) W 800 Seminole Road FNtGEt V L.� ��,��/'1_ �l• Atlantic Beach, Florida 32233-5445 • L�JJ I0 Phone(904)247-5826 • Fax(904)2 84f164- 1 4 N 6R 2,3 14.10m E-mail: building-dept@coab.us • • 202Q Date routed: ( r City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1� Et°C,: I ' •nt review required Yes No uildin• Applicant: S _ t-- anning &Zoning Tree Administrator Project: -'--� 'ublic Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: 7 Approved. I (Denied. INot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b • Date: TREE ADMIN. Second Review: Approved as revised. Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. I 'Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 �.: � City of Atlantic Beach APPLICATION NUMBER r �� Building Department (To be assigned by the Building Department.) - i-- .')= 800 Seminole Road �l ```` 2,3 ,n - - r Atlantic Beach, Florida 32233-5445 �i �CEv_ v� -'Y Phone(904)247-5826 - Fax(904)247-5845 ,').,;11} ' ,;,1> E-mail: building-dept@coab.us Date routed: l 411 _ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: is,BL5 1... E--Aei—Cnt review required Yes No \ uildin Applicant: C—i�ZtY\S P--:2J C_C ening &Zoning Tree Administrator' Project: - ' PLI>C L s- . �) Public Utilities` "> Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District 4.4 Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING / 3 - I e lc, Reviewed by., Date: TREE ADMIN. Second Review: I 'Approved as revised. I 'Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 rs Ari;j City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) r 800 Seminole Road } / /l ` a Atlantic Beach, Florida 32233-5445 I 1�')CE v— V \ Phone(904)247-5826 • Fax(904)247-5845 Z4).30-- E-mail: building-dept@coab.us Date routed: 1 _ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: L E EE E Erati. I - ; • •nt review required Yes No auildin. Applicant: -1G7mS l 6L_ `—, " anning &Zoning Tree Adm n stra or . Project: 4 �L3 CC--- - 'ublic Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept.of Environmental Protection Florida Dept.of Transportation K..4St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Vr pproved. Denied. I INot applicable (Circle one.) Comments: CUILDIN)G PLANNING&ZONING Reviewed by: PI Date: af-/^a-C) TREE ADMIN. Second Review: nApproved as revised. Denie . Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 JCB COPY r . Building Permit Application Updated 10/9/18 U ) City of Atlantic Beach Building Department **ALL INFORMATION Mr°+ r800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REWIRED. Job Address: `r is 2t4 t,1, Ay•L, Aiiik.4Rt ,'' ' t_44 Permit Number: I- klC E2 O- 0 VZ 3 Legal Description / RE# I. 6 Valuation of Work(Replacement Cost)$ gf O• C70 Heated/Cooled SF Non-Heated/Cooled • Class of Work: g(Jew ❑Addition :Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential LLI �0 • If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No c.) • Will tree(s)be removed in association with proposed project?❑Yes(must submit separate Tree Removal Permit) Gi o CO Describe in detail the type of work to be performed: N 1.4.1 y' U h. Floris r l'Stl.,4.e. worst Caiiw <CI ZJ• O J-Y Gw . a.• tz p o O moo 1.12 Florida Product Approval# for multiple products use product approv.)oo a U G Property Owner Information . E Name !4Y"/1/Mj4 (.-M' 4 & EL_ Address /S I.J /Re LGV-e r Q Z e a City _ ,r- / ' .. State LL—Zip 3d,?.?� Phone 70I— fel-c---&- y 3'9 9 V cA E-Mail -ettie4;vi'IIr CC1�( .cl. f- er cct; i-- Z Owner or Agent(If Agent, Poyser of Attorney or Agency Letter Required) O i S W LI. ••••• 2 Contractor Information 0 0 w W j: CC Name of Company 'If;eviv�/ei►ytiV`u►4.-t. 4o. Qualifying Agent DOJOl r %'))€,/ wa 5 c Address 322(o'Alhyrau.oC 4vv. City State N i '4_ ZipJLo ZC3'' o w Office Phone 9f f .3 5-4 •2,373 Job Site Contact Number 9o'f- ?p i- ,997 . w Zl:y E-Mail , • State Certification/Registration# ! 32 , . - - _ j Architect Name&Phone# AIM CZ cc Engineer's Name&Phone# N/A) Workers Compensation Insurer OR Exempt 0 Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all th 'n construction in this jurisdiction.I understand that a separat- p: Ili t be secured for ELECTRICAL WORK,PL uN , .. IvE! WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,a 'tl A ' .3 T E c. Qrpdn to the E� f� ,permit,there may be additional restrictions applicable to fffs prop rty h e f db c records of this county,and there may be additional permits required from other goyernmentlaPfaithiesis4 Kwalitrawkigement districts,state agencies,or federal agencies. Building Department MAR 1 7 2020 City of Atlantic ch OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that anBeach ,FL be done in compliance with all'— applicable laws regulating construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCE Building Department ruY tztic each, RESULT IN YOUR PAYMG TWICE FOR IMPROVEME O YO R PROPERTY. IF YOU INTEND TO OBTAIN FINANCI ' , CONSULT WITH YOUR L DER OR A ATF12 BEFORE RECOR�DII .l f� ' ICE OF COMMENCEME . / Si nature of Owner or Agent)g g ) (Sig ature of Contracto Si ed and Lw i`rn to(or affir• •d before me this / 7day of Signed and sworn to(or affirmed)before me this . day of _ c�C -i D �� . pA, . ^ -',�,f `� A�lw•� , 10,10 ,by POO 1%% I it i' �j•�.1�. ii •.i /!__i': i •,, �` ' •.a.E '.1"i (., 31selr. ure o otary) :GO �-30,� � :,:,iivv&., ROBERT G HALL [ ersonally Known OR = .4 '' 2� �•• [s lersonally Known OR _° ..� `. Notary Public-State of Florida •[ ]Produced Identification S*: s►... :1!-_ [ ]Produced Identification ';; '��te` Commission N GG 254695 • Type of Identification: tiGG36470 ' - = Type of Identification: �Fr�° My Comm.Expires Oct 24,2022 7 •.. Bonded through National Notary Assn. �� .rDended tt`c •V��` �� .....—.me--"an. _ .1m.'S')_ • ain Incut >` i,. 0./i, ..Tn-r ' ,� LOT 3 .0 I2 o osI-A0• tr3107 Io2,90' MAIL TO C.C,C.\ FOUND NAIL BETWEEN z 16"PALM TWO PALM TREES N 93'26'53" E 200.12' NAIL TO IRON Ir' �y ,a"PALM _ _ ...... ...... _ _ N 83'29'03" E 212't — _ _ _ _ rNO LEGIBLE OUND 1/2"REAR — — zZ I Z N • 0 O Ie I • 1In rn UTlay y L0 m U� LOT 2 a N O O N Io q . * z 0 0 `, • -8 I I 1.4'X1.4' CONC. FENCE INLINK\II o w�--• • o COLUMNS W/ a I F*1 y f1' I FOUND 1/2' IRON 2' CONCRETE I a' -i PIPE, CAP La3s72 200.85^'j(RON TO REBAR) WALL & 2' WOOD 4' WOOD FENCE ! I { N 8329 03 E 213'± FENCE FOUND 1/2"REBAR, / 9' CAP NOT LEGIBLE r 0.2'1 2-BACKFLOW PREVENTERS __ -. _ ' •F'• I � �• r- 200,00'(PLAT) -� 0.1•Z Z ' V V . NNW O V di. �.0AS TANKS 51.6' C'-I 6.1' L__„____�,••,, � r UkJ.o' U1 Z.� 0^ 1 .�/f, 24.1' �Ii.8811.;',''•.:8—.. I• § ' 2 W -11 o W T ,4k,41‘^ Akrp 'c'--i2 ❑L o�o�i.;' :8' o I m ,ri, D o LA o 0 4 LOT 1 �'3 1,. •;.; N +t O• ' ow N 2 STORY N o o n, M••.-� ..,• N so im,..$ Jr?. A p STUCGO A ❑ 3 STORY STUCCO , g c� "� * Ul I iGARAGE y RESIDENCE Na 1515 ��\ % i� In Ln V 1.1;i ,<.41°K _ 22.0' / ` 2 O Lvl• , 0 N _ • J 1 Ij0 rrl 2a,�' ~i-O • a'4 2ND FLOOR -Z+ 5.9' o +—'�� 1,3.-- PA I. • POOL $ O m :fj,.?- nT.i`NOOD DECK r 14.7' N 0. Si illta- Q V*-a O �� s„, :5; N N Iv •I 4 c;s' -P YARD DRAIN 4itt1 �� O 200.00'(PLAT) 0.5' 4� 11CCD -DICE FOUND 1/2"10.0:)PIPE, r v 0.2'-� I CAP ECR t9�0E0 S 83'29'03" W 2131± 1.4'x1,4' CONC, FOUND 1/2' IRON PIPE, COLUMNS W/ ili) CAP ECI< L83080 583'29'55"W 201.55'(IRON TO REBAR) 2' CONCRETE WALL & 2' WOOD I 1 FENCE I. FIFTEENTH STREET . BENCHyARK USED pH • (FORMERLY 13TH STREET) ` �EVAnDN.^;e NAM I 40' RIGHT OF WAY (PAVED) V\1:44. C FOUND ' OhR MONI t`0, 72-81_A19 \P\'''t.„ / NORThING:J 2.183, • G: 74,SSE o . ........_A0.4SA 5�— 1j `43e98 oi1ueRV Jo 43 • I luaurpedea 6ulplin8 ' Asea 41Wi0d As paanoJddy • Aria` J gen144t1